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Radiotherapy Using Tangential Fields Increase Risk of Cancer in Other Breast

By MedImaging International staff writers
Posted on 24 Nov 2008

Women with breast cancer treated with radiotherapy using tangential fields (where radiation is directed at an angle to the breast) after lumpectomy show increased risk of breast cancer in the other breast, with an even higher risk in younger women and in those with family members who have had breast cancer, cautions a recent study.

Women who have had breast cancer have a three to four times higher risk of developing a new primary cancer in their other breast (contralateral breast cancer), compared with the risk of a first primary breast cancer in other women. More...

This increased risk could be due to a common cause for the tumors in both breasts, such as hormonal risk factors a genetic tendency to breast cancer.

Researchers have suggested that the treatment of the first breast cancer may also play a role in increasing the risk of a new cancer in the other breast. One study estimated that about one in 10 of all contralateral breast tumors in women having conventional radiotherapy for their initial breast cancer could be attributed to their radiation treatment. However, few research studies have looked at whether advanced radiotherapy and chemotherapy affect this risk, and the results have been inconclusive. Therefore, a large study was carried out to evaluate the long-term risk of contralateral breast cancer in young women, centering on the effects of the radiation dose they were given, their chemotherapy, and their family history of breast cancer.

The study included 7,221 predominantly young women treated for breast cancer at two centers in The Netherlands, The Netherlands Cancer Institute (Amsterdam, The Netherlands), and the Erasmus Medical Center (Rotterdam, The Netherlands), between 1970 and 1986. The investigators searched the patients' records for information on the treatment they were given for their primary cancers, including surgery, radiotherapy, chemotherapy, and hormonal treatment; whether they suffered recurrent cancer; and their family history of breast cancer.

The study's results showed that radiotherapy did not considerably increase the risk of contralateral breast cancer overall. However, the risk associated with radiotherapy was higher in younger women. Those who were younger than 35 years at first treatment had nearly twice the risk of breast cancer associated with radiotherapy occurring in the other breast (hazard ratio [HR] 1.78; 95% confidence interval [CI], 0.85 to 3.72) compared to women over 45 years (HR 1.09; 95% CI, 0.82 to 1.45).

The risk of contralateral breast cancer also depended on the type of radiotherapy used, which was determined by the location and stage of the primary breast cancer. Women treated before the age of 45 years with radiotherapy after lumpectomy showed a 1.5-fold increased risk of breast cancer in their other breast compared with those who had radiotherapy after mastectomy.

The researchers, led by Dr. Maartje Hooning, from The Netherlands Cancer Institute, explained why this difference might have occurred, "Postmastectomy radiotherapy using direct electron fields led to a significantly lower radiation exposure to the contralateral breast than postlumpectomy radiotherapy using tangential fields."

The investigators noted that radiation techniques for treating breast cancer have improved over the last few years. Newer approaches to improve the angle of delivery of radiation to the breast and the introduction of intensity-modulated radiotherapy have led to a lower dose of radiation to the other breast. "These policies will have the impact of reducing, though not eliminating, any potential increased risk of contralateral breast cancer owing to radiotherapy," they suggested.

The joint effects of postlumpectomy radiotherapy and a strong family history for breast cancer on the risk of contralateral breast cancer were greater than expected when individual risks were summed up (HR 3.52; 95% CI, 2.07 to 6.02; p departure from additivity = 0.043).

Treatment with adjuvant chemotherapy (cyclophosphamide, methotrexate, and fluorouracil) was associated with a nonsignificantly decreased risk of contralateral breast cancer in the first five years of follow-up but did not reduce the risk in subsequent years. "Our data suggest that chemotherapy primarily affects contralateral breast cancer risk by eradicating preexisting tumor cells in the contralateral breast," the researchers suggested.

"Young patients with breast cancer irradiated with breast tangentials experience increased risk of contralateral breast cancer, especially in those with a positive family history of breast cancer," concluded Dr. Hooning and her co-researchers. "This finding should be taken into account when advising breast radiation with tangential fields to young patients with breast cancer.

The study was published in the October 14, 2008, issue of the Journal of Clinical Oncology.

Related Links:
The Netherlands Cancer Institute
Erasmus Medical Center

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57 (373.12507629395): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294721166 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

58 (!!!!! 1173.0194091797): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721166 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721166 AND published='1' LIMIT 1

59 (56.982040405273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721166 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721166 AND published='1' LIMIT 1

60 (82.015991210938): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721166 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721166 AND published='1' LIMIT 1

61 (48.87580871582): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721166 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721166 AND published='1' LIMIT 1

62 (90.122222900391): select cover from jos_number where journalid in (5) and cover is not null order by left(issue,2)+right(issue,2)*12 desc limit 1

63 (611.0668182373): SELECT fid FROM jos_deeppockets WHERE id=294721166 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294721166 AND published='1' LIMIT 1

64 (86.069107055664): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=211 ORDER BY `ordering`

65 (68.902969360352): select jos_twitters.link from jos_twitters where cat=10

66 (50.067901611328): select jos_facebook.link from jos_facebook where cat=10

67 (36.954879760742): select jos_google_plus.link from jos_google_plus where cat=10

68 (48.87580871582): select jos_linkedin.link from jos_linkedin where cat=10

69 (63.180923461914): SELECT fid FROM jos_deeppockets WHERE id=294721166 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294721166 AND published='1' LIMIT 1

70 (56.028366088867): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=211 ORDER BY `ordering`

71 (488.0428314209): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294721166 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (272.03559875488): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294721166 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

73 (60.081481933594): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

74 (54.121017456055): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (43.869018554688): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294721166 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (29.802322387695): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294721166 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

90 (32.901763916016): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

91 (63.896179199219): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (38.862228393555): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (34.809112548828): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (34.809112548828): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (34.809112548828): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (75.101852416992): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (38.862228393555): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (72.956085205078): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721166 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721166 AND published='1' LIMIT 1

106 (44.107437133789): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721166 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721166 AND published='1' LIMIT 1

107 (49.114227294922): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294721166 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (46.968460083008): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294721166 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

109 (61.03515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721166 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721166 AND published='1' LIMIT 1

110 (44.107437133789): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721166 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721166 AND published='1' LIMIT 1

111 (47.206878662109): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294721166 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (487.8044128418): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294721166 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

113 (530.95817565918): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (298.02322387695): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

115 (77.009201049805): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721166 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721166 AND published='1' LIMIT 1

116 (45.061111450195): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721166 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721166 AND published='1' LIMIT 1

117 (45.061111450195): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721166 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721166 AND published='1' LIMIT 1

118 (37.908554077148): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721166 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721166 AND published='1' LIMIT 1

119 (42.915344238281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721166 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721166 AND published='1' LIMIT 1

120 (36.001205444336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721166 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721166 AND published='1' LIMIT 1

121 (53.167343139648): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721166 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721166 AND published='1' LIMIT 1

122 (37.908554077148): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721166 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721166 AND published='1' LIMIT 1

123 (154.97207641602): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

124 (!!!!! 18964.052200317): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

125 (562.90626525879): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294721166 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294721166 AND type='deeppockets_item' AND published='1' LIMIT 1

126 (!!!!! 7028.1028747559): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (97.036361694336): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

128 (39.100646972656): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

129 (30.040740966797): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

130 (41.007995605469): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

131 (29.087066650391): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

132 (328.06396484375): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

133 (59.843063354492): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

134 (30.994415283203): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

135 (29.802322387695): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

136 (450.13427734375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721166 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (319.9577331543): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721166 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

138 (37.908554077148): SELECT name FROM jos_deeppockets WHERE id=211

139 (31.948089599609): SELECT name FROM jos_deeppockets WHERE id=211

140 (581.02607727051): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

141 (437.02125549316): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

142 (62.942504882812): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721166 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721166 AND published='1' LIMIT 1

143 (42.915344238281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721166 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721166 AND published='1' LIMIT 1

144 (!!!!! 8094.0723419189): TRUNCATE TABLE jos_trademed_module

145 (97.036361694336): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294721166 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (56.982040405273): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294721166 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

147 (770.80726623535): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721166 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (50.067901611328): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721166 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

149 (76.055526733398): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721166 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721166 AND published='1' LIMIT 1

150 (42.915344238281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721166 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721166 AND published='1' LIMIT 1

151 (!!!!! 1230.001449585): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

152 (56.028366088867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721166 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721166 AND published='1' LIMIT 1

153 (39.815902709961): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721166 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721166 AND published='1' LIMIT 1

154 (32.901763916016): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294721166 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294721166 AND type='deeppockets_item' AND published='1' LIMIT 1

155 (29.802322387695): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=211 or channel_id is null)

156 (26.941299438477): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=211 or channel_id is null)

157 (30.994415283203): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

158 (127.79235839844): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721166 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721166 AND published='1' LIMIT 1

159 (63.896179199219): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294721166 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294721166 AND published='1' LIMIT 1

160 (36.954879760742): select jos_twitters.link from jos_twitters where cat=10

161 (30.994415283203): select jos_facebook.link from jos_facebook where cat=10

162 (32.186508178711): select jos_google_plus.link from jos_google_plus where cat=10

163 (30.994415283203): select jos_linkedin.link from jos_linkedin where cat=10

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